The Amsterdam Wrist Rules

Wrist trauma is one of the most common Emergency Department (ED) attendances and accounts for approximately 20% of all injuries. Only 39% of patients with wrist trauma have a fracture; however, most patients are routinely referred for radiography. This study had the purpose of deriving and externally validating a clinical decision rule able of selecting patients with acute wrist trauma in the Emergency Department for radiography.

A clinical prediction model estimates the risk of a certain outcome. A clinical decision rule recommends an action to the predicted risk. In this study, the recommendation would be to request an X-ray yes or no.

The Amsterdan wrist clinical prediction rule showed a high sensitivity (98%) and negative predictive value (90%) for fractures of the wrist. As yet no guidelines or criteria were available. The Amsterdam Wrist Rules can provide physicians with an externally validatedscreening tool trauma in the Emergency Department

The formula for The Amsterdam Wrist Rules, predicting the probability of a fracture will be made available in a smartphone application. Upon entering the clinical variables, the application will calculate the probability of fracture and give a recommendation (X-ray yes/ no).

The Amsterdam Wrist Rules is a clinical prediction rule with a high sensitivity and negative predictive value for fractures of the wrist. The Amsterdam Wrist Rules can provide physicians in the Emergency Department with a useful screening tool to select patients with acute wrist trauma for radiography.

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